I don’t know a woman alive who doesn’t cringe or go a little pale and quiet when they hear the word “pap smear” – that’s certainly my reaction!
The thought of it sends me into a little bit of a panic, even though I try to act really nonchalant about it on the outside. To my friends, I’m like – “Yeah, going to have a pap smear today – pfft!” – in the same sort of tone as if I was to say “Yeah, I’m going shopping today.” You always get that knowing, sympathetic look from other women though…always!
Honestly, I have pushed two watermelon-sized heads out of my vagina (i.e my beautiful big-headed babies!) but I still can’t deal with the whole pap smear thing! It’s not that it hurts particularly, but it’s just the whole procedure that really just makes me extremely uncomfortable – the whole speculum thingy and just the fact that it’s a foreign object being put somewhere that it really shouldn’t be put (although I guess there are some people who do like that sort of thing, but that’s another story for a completely different website to this altogether!)
Anyway, all that being said, I diligently go to my GP every two years and lie on the little bed with my undies off and a sheet (with soccer-ball motifs – WTF?) on my legs with my pink bits displayed to the world (well the doctor, but it feels like the world!). I keep telling myself that despite this being something I dread, I would prefer it to the alternative of not having regular pap smears. When you put it all into perspective, it’s really not THAT bad and I think I’d rather be a woman and have that done than a man and have my prostate checked (if you know what I mean!). I encourage every woman to have regular pap smears, and here’s some information you should all read!
What is a Pap Smear?
Pap smear is a screening tool (named after Dr Papanicolaou who discovered it in 1928) used to check changes in the cervix. It detects early (pre-cancerous) changes in cervical cells, but is not a diagnostic tool for cancer. If changes are found, it indicates the need for further diagnostic procedures to determine whether or not the changes are cancerous in nature.
The pap smear is a very simple procedure carried out by your GP (or women’s health nurse). You will be asked some health-related questions by your doctor (mostly family health history, about your period, sexual partners and any symptoms you may have found unusual) and also have a quick blood pressure check.
Then you will be asked to remove your clothes from the waist down (everything!) and lie on a bed – you should be given privacy (a curtain and a sheet). The doctor will then put on some surgical gloves (and make sure they do!) and ask you to place your feet flat on the bed with your knees bent and then open your legs.
Then comes the cringy part! The doctor will insert an instrument called a speculum into your vagina (cervix) and secure it. The best thing you can do while this is happening is relax, otherwise, it will feel more uncomfortable than it should! Take slow deep breaths and try and make small talk with your doctor or just think of nice things. The doctor will then insert a swab and take some cells from your cervix. The cells are smeared onto a pathology slide which is then sent to a laboratory where the cells are tested.
If abnormal changes are found at screening, further tests will be done to see if treatment is needed. It does not detect ovarian cancer or any other cancers of the reproductive system, only changes in the cervix. The whole pap smear procedure only takes a few minutes. Sometimes, you might have some light spotting afterwards or a little bit of an uncomfortable feeling in your lower abdomen, but this will pass within a few hours. If you do experience severe pain or heavy bleeding after a pap smear, then please go back to your GP immediately!
Should I be worried about Cervical Cancer?�
Yes! Treatment of cervical cancer is more difficult the more progressed the cancer is. More often than not, cervical cancer has no symptoms in the early stages and can be quite aggressive and fast moving. All women who have ever had sex (even once!) are at risk of developing cervical cancer. The risk of this increases as you get older and with the more sexual partners/activity you have had. One of the main causes of cervical cancer is the Human Papillomavirus (HPV) -�a sexually transmitted infection which in most cases is cleared by the body’s immune system within 8-14 months. The presence of HPV may be detected by the pap smear and some women who have persistent infections of HPV may develop abnormalities of the cervix, including pre-cancerous cells. Even women who have gone through menopause or who have had a hysterectomy are still at risk and should continue to have regular pap smears.
How effective is the Pap Smear?
According to the Australian�Department�of Health and�Ageing, it is recommended that all women over 18 years of age who have ever been sexually active (even if it is months or years in between “bonk sessions”!) should have a pap smear.
This can help to prevent up to 90% of common cervical cancers. There are some instances where an insufficient sample is taken or a false test result comes back – in this case, you will simply be asked to go in for a repeat pap smear.
So, in a nutshell, the best thing to do for your health and also for your family, is to spare a few minutes every two years and have the smear done. It’s better to have a little discomfort than to suffer cancer and leave your kids without a mum! Oh and while you’re at it – get your boobies checked too!
For more information about Pap smears go to the Australian Government Cancer Screening website.�or check out our suggested health hotlines and websites.
SAHM takes no responsibility for any illness, injury or death caused by misuse of this information. �All information provided is correct at time of publication.
Responses to “Pap Smears – The Good, Bad and Ugly”
I wanted to share a tip for readers, like me, who have a phobia about pap smears.
Try inserting the speculum yourself. My gp was happy for me to do this on my last visit – we had already had two attempts – and I found it was not nearly as uncomfortable. I was able to relax enough to insert it and then she did the rest.
Unluckily, the rates of abnormal pap smears, cervical dysplasia and cervical cancer is increasing extensively in the post-HPV vaccination population – and in an age group of girls who should not be having these abnormal pathologies.
http://www.womenhealthzone.com/category/tests-and-treatments/pap-smear/
I don’t have pap tests, I looked at the evidence more than 30 years ago and as a low risk woman, it was an easy decision to decline testing. Now I understand I’d be HPV- and cannot benefit from pap testing,
Initially though it was the numbers that made no sense to me, near zero risk of cervical cancer (lifetime risk is 0.65%) v 77% lifetime risk of referral for colposcopy and usually some sort of biopsy, far too much for me to cover a remote risk. I would not be interested in accepting much risk at all to screen for a rare cancer.
I’d urge women to do their reading, our program is excessive and outdated, it should have been changed a long time ago. It’s currently under review, but I fear excess will be protected, not women.
Take a look at the evidence based programs, the Finns have had a 7 pap test program, 5 yearly from 30 to 60, since the 1960s and they have the lowest rates of this cancer in the world and refer FAR fewer women for colposcopy/biopsy/over-treatment. We “treat” more than ten times the number of women than the Finns. Our program seriously over-screens women and this greatly increases the risk of a false positive and potentially harmful over-treatment for no additional benefit.
The Dutch have the same program as the Finns, but will move with the evidence again, putting women first. They’ll scrap population pap testing that worries and harms so many women and offer instead 5 HPV primary tests at ages 30,35,40,50 and 60 (or women can self-test with the Delphi Screener) and ONLY the roughly 5% who are HPV+ and at risk will be offered a 5 yearly pap test. (until they clear the virus) This will save more lives and take most women out of pap testing and harms way. Those women who are HPV- and no longer sexually active or confidently monogamous might choose to stop all further testing.
Australia does everything to increase risk for no additional benefit. Over-screening also, shows a disrespect for the bodily privacy of women.
The best decision I ever made was to do my own research and make an informed decision and in my case, that was to decline testing. I’ve recently also, made an informed decision to decline mammograms. I’d urge women to head over to the Nordic Cochrane Institute website, an independent medical research group, and read their excellent brochure on the risks and benefits of mammograms. About 50% of screen detected breast cancers are over-diagnosed, the fall in the death rate is mostly about better treatments, not screening. Also, any benefit is wiped out by those women who die from lung cancer and heart attacks after treatments.
There is no respect for informed consent in women’s cancer screening and that’s unacceptable, it is a legal and ethical requirement for all cancer screening. Sadly, there are powerful vested and political interests in women’s cancer screening. Men are not treated in this way, real information came out quickly for prostate screening and doctors were advised to obtain informed consent, neither the rectal exam or PSA testing is recommended.
Also, we should not be paying doctors to reach screening targets for pap testing, it is a potential conflict of interest that should at the very least be mentioned to women. (PIP scheme)
More Australian women are thankfully, getting to the evidence and making an informed decision to screen less often or not at all. Others are seeking HPV testing or ordering HPV self-testing online…then they know where they stand, HPV+ and they have a small chance of benefiting from a 5 yearly pap test, HPV- and they cannot currently benefit from pap testing and might choose to test again for HPV in another 5 or 10 years (depending on their age). Or forget about further testing if they’re HPV- and no longer sexually active or confidently monogamous.
HPV Today, Edition 24, sets out the new Dutch program.
Delphi Bioscience can provide information on HPV self-testing. (also, in Singapore and I understand an Australian supplier is not far away)
Women under 30 need to be VERY careful, no country in the world has shown a benefit pap testing young women, but this group produce the most false positives, over-treatment can damage the cervix and lead to premature babies, miscarriages, c-sections etc. HPV testing is not recommended either before age 30 as 40% would test positive, almost all are transient and harmless infections, by age 30 only 5% will test HPV+ and these are the women who have a small chance of benefiting from pap testing. HPV testing should always stand alone, not adding to population pap testing for all women, this leads to the most over-investigation.
Most women are having unnecessary pap testing that simply risks their health…those women who wish to test should write to the Govt and demand access to HPV primary testing and HPV self-testing.